Provider Demographics
NPI:1932319647
Name:KOHLI, MANINDER KAUR
Entity Type:Individual
Prefix:MRS
First Name:MANINDER
Middle Name:KAUR
Last Name:KOHLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 EAST FLORIDA AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544
Mailing Address - Country:US
Mailing Address - Phone:951-765-1333
Mailing Address - Fax:951-765-1444
Practice Address - Street 1:2390 E FLORIDA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92544-4707
Practice Address - Country:US
Practice Address - Phone:951-765-1333
Practice Address - Fax:951-765-1444
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT29722174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist